CHAPTER ONE: INTRODUCTION

1.1. Background

Anaemia is a condition in which the number of red blood cells or haemoglobin concentration within them is lower than normal [1]. According to the WHO guidelines, anaemia in pregnancy is defined as a haemoglobin level <11g/dl which is a diagnostic of anaemia [2]. Anaemia is a global public health problem affecting both developed and developing countries with major consequences for human health as well as social and economic development [3]. Anaemia in pregnancy may also lead to premature births [4], low birth weight [5], foetal impairement and infant deaths [6]. Iron deficiency type of anaemia is most prevalent due to nutritional deficiency all over the world [7].

The prevalence, aetiology, and degree of severity vary in different populations, it is 35% for non-pregnant women and 51% for pregnant women globally, and 3-4 times higher in developing countries [8]. A study in 2013 showed that anaemia is more prevalent in developing countries (43%) than developed countries (9%) [9]. Multiparity, poor socio-economical and educational statuses are the principal reasons for high prevalence of anaemia in our population [10]. A study was conducted to highlight this situation in pregnant women of Jinnah Medical College Hospital in Korangi Industrial Area Karachi. Majority of diagnosed anaemic pregnant women were those who had poor dietary intake [11]. Sub Saharan Africa accounts for the highest number of anaemia in pregnant women worldwide with a prevalence of 57% as of 5^th October, 2022 [12].

In Cameroon the prevalence rate of anaemia in pregnancy stands at 44.4% as of 2019, with 782 deaths per 100,000 live births occurring. This indicates that Cameroon can be considered amongst the sub-Saharan African Countries with the highest prevalence of maternal mortality [13]. In addition, daily maternal mortality cases in the country stand at 12-13 cases [14].

Physiologically, plasma volume expands by 25-80% of pre-pregnancy volumes between the second trimester and the middle of the third trimester of pregnancy [15]. This induces a modest decrease in Hb levels during pregnancy [16]. Previous studies show that the best time to investigate any risk factors associated with anaemia may be up until 20 weeks of gestation [17].

A lot of symptoms and signs may company this clinical state, to a variable degree. The commonest of these are headache, fatigue, lethargy, paresthesia, and the clinical signs of tachycardia, tachypnea, pallor, glottis, and cheilitis [18].

Published literature shows that many countries have a national policy to prevent and treat anaemia in pregnancy. These include the provision of haemanthics (ferrous sulphate and folate acid) to pregnant mothers during pregnancy [19]. The management of anaemia in pregnancy has been recommended as a potentially feasible and cost-effective intervention to reduce maternal, foetal, and perinatal mortality and other adverse outcomes [20]. Anaemia prevalence data remains an important indicator in public health since anaemia is related to morbidity and mortality in the population groups usually considered to be the most vulnerable; pregnant women and children under five. Anaemia prevalence study is also useful to monitor the progress of reproductive health [21].

1.2 Problem Statement

Statistics show that anaemia is one of the leading causes of death among pregnant women globally. Iron deficiency anaemia is reported to be the most common cause of anaemia among pregnant women resulting from poor nutritional habits, this occurs when the body doesn’t have enough iron to produce adequate amount of haemoglobin. Anaemia in pregnancy has been and is still a global public health challenge as it has been the reason for a high maternal and neonatal mortality and morbidity making research on this subject an absolute necessity. The problem identified in the study is that pregnant women with anaemia don’t have healthy red blood cells or haemoglobin to carry oxygen from the lungs to all other organs of the body causing tiredness, weakness, and shortness of breath.

1.3 Rationale of the study

Anaemia is directly or indirectly responsible for 40% of maternal deaths in developed and developing countries but most especially in developing countries. It is a major cause of mortality and morbidity during pregnancy and increases the risks of fetal and neonatal mortality and morbidity [20]. In addition, haemoglobin concentration turned to fall than normal in pregnant women especially due to the fact that most pregnant women have inadequate or no knowledge on the type of food to consume during their gestational period [21]. Given the fact that anaemia according to previous studies have been classified a global public health concern, the aforementioned and a host of other factors have made carrying out further research on this topic an absolute necessity. Therefore this study aims to determine the prevalence of anaemia in pregnanat women, assess the severity of anaemia in pregnant women attending antenatal clinic of the Regional Hospital Bamenda.

1.4 Research Questions:

1. What is the prevalence of anaemia in pregnant women attending antenatal clinic at the Regional Hospital Bamenda?
2. What is the severity of anaemia in pregnant women attending antenatal clinic at the Regional Hospital Bamenda?

1.5 Research Hypothesis

Specific objective 1

Null hypothesis: There is no prevalence of anaemia in pregnant women attending antenatal clinic at the Regional Hospital Bamenda.

Alternative hypothesis: There is a prevalence of anaemia in pregnant women attending antenatal clinic at the Regional Hospital Bamenda.

Specific objective 2

Null hypothesis: There is no severity of anaemia in pregnant women attending antenatal clinic at the Regional Hospital Bamenda.

Alternative hypothesis: There is a severity of anaemia in pregnant women attending antenatal clinic at the Regional Hospital Bamenda.

1.6 Objectives

1.6.1 Main Objective

To determine the prevalence and severity of anaemia in pregnant women attending antenatal clinic at the Regional Hospital Bamenda.

1.6.2 Specific Objectives

1. To determine the prevalence of anaemia in pregnant women attending antenatal clinic at the Regional Hospital Bamenda.
2. To assess the severity of anaemia in pregnant women attending antenatal clinic at the Regional Hospital Bamenda.